National Provider Identifier [NPI]: |
1104868967 |
Last Name Of The Provider |
MACDONALD |
First Name Of The Provider |
LAWRENCE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
44000 W 12 MILE RD |
Street Address 2 Of The Provider |
SUITE 113 |
City Of The Provider |
NOVI |
Zip Code Of The Provider |
483772644 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
2794 |
Number Of Medicare Beneficiaries |
729 |
Total Submitted Charge Amount |
645725 |
Total Medicare Allowed Amount |
299156.82 |
Total Medicare Payment Amount |
229157.68 |
Total Medicare Standardized Payment Amount |
226095.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
2794 |
Number Of Medicare Beneficiaries With Medical Services |
729 |
Total Medical Submitted Charge Amount |
645725 |
Total Medical Medicare Allowed Amount |
299156.82 |
Total Medical Medicare Payment Amount |
229157.68 |
Total Medical Medicare Standardized Payment Amount |
226095.52 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
277 |
Number Of Beneficiaries Age 75 to 84 |
210 |
Number Of Beneficiaries Age Greater 84 |
121 |
Number Of Female Beneficiaries |
383 |
Number Of Male Beneficiaries |
346 |
Number Of Non Hispanic White Beneficiaries |
548 |
Number Of Black or African American Beneficiaries |
167 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
571 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
158 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
55 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.3748 |